ASN Kidney Week 2019 Recap

Kidney Week 2019, organized by the American Society of Nephrology (ASN), was held Nov. 5-10 in Washington, D.C. Approximately 13,000 kidney professionals from around the world attended. Similar to previous years’ meetings, Kidney Week 2019 provided attendees ample opportunities to exchange knowledge, learn about the latest scientific and medical advances and participate in engaging conversations with leading nephrology experts through scientific and plenary sessions, poster presentations, educational symposia and welcome receptions. The DaVita team presented 10 abstracts during the meeting, with eight shown as posters and two highlighted as oral presentations. A full view of the research posters can be found at DaVita Clinical Research and high level overviews shared on the @DaVitaDoc Twitter profile, such as a tweetorial on Adoption of Home Remote Monitoring to Improve Outcomes in Peritoneal Dialysis Patients.

With the signing of the executive order on July 10, 2019, to launch Advancing American Kidney Health (AAKH) and the related payment models proposed by the Center for Medicare & Medicaid Innovation (CMMI), this was a new and compelling topic of discussion this year. This year’s Kidney Week inspired participants and left many colleagues with a sense of hope regarding the future of kidney care. DaVita’s Office of the Chief Medical Officer (OCMO) physicians shared their favorite experiences or key learnings from the conference below.

• I was very impressed by the interest and energy at ASN around moving upstream to CKD and focusing on transplantation. This is only reinforced by the executive order and CMMI proposals. There is an amazing amount of innovation going on in the space and our renewed focus on these areas, along with home dialysis, should serve us and our patients well going forward.
  —Allen R. Nissenson, MD, FACP, FASN, FNKF
• Some key takeaways for me included:
  • Managing patients with a new cocktail of drugs sodium-glucose sotransporter-2 (SGLT‑2) inhibitors, aggressive use of patiromer and mineralocorticoid inhibition, all with the intent of modifying cardio-renal syndrome
  • The energy around the opportunity suggested by the AAKH initiative riding a wave of general rejuvenation of the profession of nephrology
  • An emphasis on patient-centeredness from language to actions to getting more personalized with therapeutics
  • Inclusiveness in the profession and the expansion of influence of social media, with younger nephrologists leading the way
  • Re-examination of cell-based therapies and new devices that are designed to replace a bit of kidney function
    —Bryan Becker, MD, MMM, FACP, CPE
• Lots of interesting data were presented on SGLT-2 inhibitors and their effect on cardiovascular events, hospitalizations and progression of CKD. These agents may have the same effects in non-Type 2 diabetes mellitus (DM) as in Type 2 DM. —George R. Aronoff, MD, MS, FACP, FASN
• Exciting data on hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHI), oral agents to treat anemia, showed safety and efficacy and will have major application to anemia in CKD patients not on dialysis, incident in-center hemodialysis patients and home patients. —Robert Provenzano, MD, FACP, FASN
• Disease-modifying agents that I saw addressed in one form or another at ASN included SGLT-2s, endothelin A (ETA) receptor antagonists and HIF-PHIs. Additional hopeful signs:
  • The first United States Renal Data System (USRDS) reports on end of life on the one hand and falls on the other
  • The first mention to my knowledge of the word “deprescribing” in a presentation on pharmacotherapy in dialysis patients. Deprescribing was defined as a deliberate, evidence-based, patient-specific, algorithmic approach to identifying drugs that have been shown to be ineffective or harmful or have an evidence base establishing no indication. —David Van Wyck, MD
• The larger picture message may be that for the first time in a while it seems like we have definitive data supporting the use of new therapies with which to treat our CKD (and ESKD) patients. This combined with the increased payment focus on CKD (and nephrology in general), I would say this ASN left me feeling more hopeful than I have been in a while. —Adam Weinstein, MD
• It was wonderful to see so much research addressing gender, racial and socioeconomic disparities in kidney care. All people regardless of background should have access to safe and effective care and it’s heartening to see this discussed more openly now. In addition, as an international nephrologist:
  • I found the sessions on changing geographical disease patterns and emerging new kidney disease entities (eg. CKD of undetermined causes [CKDu]) as the global climate alters fascinating and worrying.
  • It was also good to hear about new technologies designed to waste less resources as well having a better environmental footprint.
  • There was much food for thought and new care models to consider exploring further internationally, such as incremental start, expanded dialysis and better biomarker use. —Partha Das, MBBS, MRCP (Neph), Msc
• I found the molecular genetics of future therapies absolutely fascinating. On the vascular access front, some of the information provided were useful and some were worthless. —David Mahoney, MD
• With many sessions focused on HIFs, SGLT-2 inhibitors and policy changes, the meeting was filled with excitement about innovation and the future. —Mahesh Krishnan, MD, MPH, MBA, FASN

Speaking of the future, we look forward to ASN Kidney Week 2020, when the conference will be held at the Colorado Convention Center in Denver, basically in our headquarters’ “backyard”. We hope to see you there!